Phosphate Binders and Nonphosphate Effects in the Gastrointestinal Tract

Annabel Biruete, Kathleen M. Hill Gallant, Stephen R. Lindemann, Gretchen N. Wiese, Xuening (Neal) Chen, Sharon Moe

Research output: Contribution to journalReview article

Abstract

Phosphate binders are commonly prescribed in patients with end-stage kidney disease to prevent and treat hyperphosphatemia. These binders are usually associated with gastrointestinal distress, may bind molecules other than phosphate, and may alter the gut microbiota, altogether having systemic effects unrelated to phosphate control. Sevelamer is the most studied of the available binders for nonphosphate-related effects including binding to bile acids, endotoxins, gut microbiota–derived metabolites, and advanced glycation end products. Other binders (calcium- and noncalcium-based binders) may bind vitamins, such as vitamin K and folic acid. Moreover, the relatively new iron-based phosphate binders may alter the gut microbiota, as some of the iron or organic ligands may be used by the gastrointestinal bacteria. The objective of this narrative review is to provide the current evidence for the nonphosphate effects of phosphate binders on gastrointestinal function, nutrient and molecule binding, and the gut microbiome.

Original languageEnglish (US)
JournalJournal of Renal Nutrition
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

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Gastrointestinal Tract
Phosphates
Iron
Hyperphosphatemia
Advanced Glycosylation End Products
Vitamin K
Bile Acids and Salts
Folic Acid
Endotoxins
Vitamins
Chronic Kidney Failure
Ligands
Calcium
Bacteria
Food
Gastrointestinal Microbiome

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Nephrology

Cite this

Phosphate Binders and Nonphosphate Effects in the Gastrointestinal Tract. / Biruete, Annabel; Hill Gallant, Kathleen M.; Lindemann, Stephen R.; Wiese, Gretchen N.; Chen, Xuening (Neal); Moe, Sharon.

In: Journal of Renal Nutrition, 01.01.2019.

Research output: Contribution to journalReview article

Biruete, Annabel ; Hill Gallant, Kathleen M. ; Lindemann, Stephen R. ; Wiese, Gretchen N. ; Chen, Xuening (Neal) ; Moe, Sharon. / Phosphate Binders and Nonphosphate Effects in the Gastrointestinal Tract. In: Journal of Renal Nutrition. 2019.
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